“Too Fast, Too Soon, But Exactly the Right Plan – A Commentary” by Dianne H. Timmering


The recent strategy from the Governor’s administration, while ideal and brilliant as they reached into the inner-workings of the legislative process to determine procedurally what they could do with a supermajority in both chambers in the first five days, it was simply – too much, too fast, too soon.

But it wasn’t wrong.

And reasons for tort reform, namely Medical Review Panels, not passing this week, because it will during the regular session in February, we strongly believe, had to do with other “powers,” I see that now, rather than totally having to do with complications of understanding its “language” as currently written. First of all, in an unprecedented Saturday move, seven bills passed the House, and as we understand it, the Governor will sign them all or already has, in the 10 day period to follow. It was just a lot.To be clear and fair, the MRP bill submitted in the Senate by Dr. Alvarado, a good friend of ours, was legislation de-shelved from a few years back and enhanced, written in fact so it would easily defy a constitutional challenge. It did not have all the “teeth” we wanted, but that was and will be tweakable in future amendments or regulatory enhancements in the following session.

Regardless of your politics, it was incredulously and profoundly fantastic to find a current Governor unconcerned about a future election and only focused on the fact that for decades key business pro-legislation had been held up by a previous legislature mired in broken-down years of cronyism. The new legislative supermajority is now steeped with the vicissitudes of opportunity going for “broke” in the first five days of the legislative session. Who could blame them!?

Their intent was to pass: Prevailing wage repeal, Right to Work, a form of Tort Reform and a few other “tee-ed” up policies which have been both “alive” and “dead” on the docket for years.

Simply, Kentucky business is mad and the government is responding, finally. Even as you listen to the declining statistics around businesses and doctors leaving the commonwealth or never coming in the first place, because of government restrictions and regulatory laws where businesses would find themselves challenged even before opening their doors; there is hope.

The irony is that Kentucky is a poor state and needs business with jobs, good paying jobs but instead it seems we have relied on the perpetuation of the “welfare” state where coveted tax dollars go to those who presumptively needed the most help (good in social theory, but is it true?).

Many make fun of “trickle-down” economics from the supply-side brigade, but the truth is that the right kind of economic policy does trickle-down into job opportunity, food on the table, purposeful paths and new taxes for local and state governments to truly help those in need, sustain a real Medicaid dollar for our elders, those with mental health needs, helpless children, etc., not just for those who have learned to maneuver around in the current system and take advantage of its antediluvian ways.

(That’s why in the dismantling of Medicaid expansion in its current form, the new waiver will require able bodied folks to work and pay a co-pay, while taking care of the “least among us.”)

The Governor’s, and House and Senate leaderships’ strategy was surreal – pushing through prevailing wage repeal (ensuring wages are more representative of actual wages paid in respective regions) and Right to Work which could unleash international companies across the borders of our “map” with immediacy, especially with the new coggled mindset from the incoming Trump administration for jobs to stay in the confines of the U.S. manufacturing legacy. So timing could prove as fruitful as God’s timing even when it seems that opportunity is lost.

Medical Review panels, for example, did not pass this week, not because of opposition but for the following reasons – one being that the bill had facets to it about which the new members needed to be educated including defining some of its “language.”

But I personally think, in reflection after the last 72 hours, it had much more to do with something else and that is what DID pass on Saturday, was very emotional to many and the House leadership “chose” to slow down MRPs because of the outcry from the labor unions against the Right to Work law, as well as the emotionality around Senate Bill #5 and HB 2 (the Ultrasound Informed Consent Act).

I watched the governor very compassionately meet and converse with a big protest of labor union workers on Saturday morning who had gathered in the Rotunda. Truly, the labor union folks touched my heart. The governor in his wisdom, listened to the leaders, even if he disagreed, but honored their voices. Labor unions will still exist, they just can’t require a worker to join and pay dues to keep their job. We are surrounded by states with Right to work laws – it was time. And now new business will come to our borders.

But an even bigger reason may have had to do with the more controversial SB 5 and HB 2. When I was in Frankfort on Friday, that was the buzz because of its nature – after the 20th week, no abortion can take place and HB2 mandates an ultrasound. Regardless of where one stands on these issue, both sides respected, there was opposition to this bill, but it seems that the five-day strategy benefited this passage.

Objectively speaking, high emotion with a cross-section of bills from both the social and business sectors sidelined MRPs, now a priority left on the agenda for the following month. The governor knows its importance to us!, Leader Hoover, others, the head of the Health and Welfare committee ….

A group of healthcare leaders, the KHA, the KAHCF, met with Chairwoman Addia Wuchner of H&W, a former nurse, in a private meeting on Friday after the chamber adjourned. She was quiet, but asked us to trust her, saying very little beyond that, but giving every indication that MRPs will pass just that there was different work ahead for the immediate moment.

Now, seeing what did pass, and intuiting on the momentum of the week, the reasons for her statement have come now to more of a divine light to me.

Leader Hoover has performed perfectly this week, allowing his “youngest” members to flex a little bit of questioning muscle. They deserve their “day in court” (pardon the pun), but with it so close to the endzone, especially with the outcry of the business community, and what is truly best for the state of healthcare, as well as a long be-speckled past of attempts at passage even with due process and a right to a jury trial in-tact, and the Governor’s mandate for tort reform beginning with the passage of Medical Review panels, it is time for it to pass. It seems to me that politics and business definitely overlap – it involves, strategy, timing, patience and well, politics.

Next steps – Members will privately caucus now, the veterans educating the new, as will we educate, before the House chamber meets again on Feb. 7, and MRPs will find its light of day. It doesn’t mean we won’t have to watch for any opposition by the trial attorneys but we will fight with fortitude and win.

The truth is – tort reform is a not even a healthcare issue (although you could make the case that it is life or death depending on access to the right care and insurance rate affordability); it is so much grander, it is a pro-business indication of a thriving community allowed to innovate, set prices (another reason we need it – bc SNF can’t even set our own prices to overcome litigation unfairness), contain costs and operate within the parameters of set strategic mission and passionate cause.

Let a measure of supply and demand do its job as an organic indicator of good and bad business. Let our quality of care speak for itself, or not. At the end of the day, tort reform is a pro-business magna carta – a form of freedom and definitely an open portal for “life-rafts” to not only survive but cross streams through the opening doors of Kentucky—no longer needing to be pried open, but with a swan-like grace, opening, welcoming, and ready.

By Dianne H. Timmering, MBA, MFA, CNA



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